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, • , . , . <br /> 4. Descriptioa of the Vertical H�t Eac6aager—Coustructioa Detail.Please supply the following infora�ation where appropriate.If ttue vertical <br /> heat exchangers ere not yet c;on�ucted,writc in the estimated depths,size,c,and dates. <br /> Number o oles Hole Depth{s) DiameOer of Piping(s) Antici�ted Depth to Bedrock <br /> �2 �5 3/4" 268' <br /> fiping Material <br /> � High D�msity Polyethyle�e ❑ O�� <br /> Grouting Material <br /> ❑ Neat Cement ❑ Cemem Sand � Bentonite ❑ 'Chermally Enhanced Bentonite ❑ Other <br /> Heat Tranafer Fluid <br /> � USP-Grade or Food-Grade Propylene Glycol ❑ Other <br /> 5. D�eeriptioa of the Hest Pump Unit <br /> Neme of Manufacturer Model No. Maximum Flow Rate <br /> wAT6�f'rJr2/�1 H%� ~�2 ��Y Z� gpm <br /> Name of i�amller <br /> SEr�� M�ta-t �c�►►`. 5�R�/r��5 <br /> �9��� Installation I)ate(Ach�al or Propased) <br /> Maximum �t0 Minimum � P 1 O — 1 ^ ( '�j <br /> 6. Location ot Vertical Heat Exc6aager. <br /> Indicete the location of the vertical h�t exchanger on an attached site plan showing isolation distances fcom water-supply wells, <br /> power lines,gas lines,LP tanks,buildings,and property lines. <br /> The site alan diagram mast be attachaf. <br /> As a condition of this pemut,I agree to construct this vertical heat exchanger under the provisions of NGnnesota Statutes, <br /> Chapter IQ3t and the rules adopted nnder it. <br /> Signature � <br /> (Certified Representative) (mm/dd/yyyy) <br /> As a condition of this permit,I agree to operate and maintain this vertical heat exchanger under the provisions of Minnesota Statutes, <br /> Chapter 103I and rules adopted thereunder and to allow inspection by the commissioner of health or his/her agent during regulaz work <br /> hours. <br /> D� July 1, 2013 <br /> Signature <br /> Owmer of Propercy) (�d�riri) <br /> origs�FJeat Loop Application and Memo.doc 7l21/201 I R <br /> 2 <br />